Do you qualify?

First Name

Email*

What industry(ies) are you involved in?*

How did you learn about Biocybernaut and what do you know of our organization?*

Link to your Instagram account

Link to your Twitter account

Link to your YouTube channel

Do you have a podcast? Please provide details as to episode frequency and listeners.

How do you interact with your audience? Ex.: regular blog posts, regular newsletters/emails, social media posts, social media commenting/engaging directly with audience, regular videos, private membership group, podcasts, word of mouth

How many active email subscribers do you have?

What are your open rates?

How would you describe your audience as a whole?

What are the known demographics of your audience?

Should you have a positive experience, how many people do you confidently feel would enroll at Biocybernaut based on your recommendation?

Are you willing to agree to a social media contract that provides certain parameters in exchange for a possible subsidy of our brain training programs?

Do you have any traditional media assets? (Ex.: magazine, TV, etc.)

What is your mailing address?

Is there anything else that you would like to share?